Provider First Line Business Practice Location Address:
980 E TAHQUITZ CANYON WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-6708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-416-6000
Provider Business Practice Location Address Fax Number:
760-416-6038
Provider Enumeration Date:
03/12/2007